IM患儿EBV DNA载量与外周血CTL细胞、TLRs表达和临床转归的关系

Association of EBV DNA load and peripheral blood with CTL,TLRs and clinical outcomes in IM children

目的 探讨传染性单核细胞增多症(IM)儿童EB病毒(EBV)DNA载量与外周血细胞毒性T淋巴细胞(CTL)、Toll样受体(TLRs)表达和临床转归的关系。方法 选取2020年1月-2021年8月在商丘医学高等专科学校第一附属医院就诊的92例IM患儿为研究对象,采用逆转录聚合酶链反应(RT-PCR)检测患儿血清EBV DNA载量,根据EBV DNA载量中位数水平(3.50×104copies/ml)分为低载量组(46例)和高载量组(46例)。采用流式细胞仪检测患儿外周血CTL细胞(CD8+T细胞)表达水平,采用RT-PCR法检测TLR7和TLR9 mRNA表达水平。分析IM患儿EBV DNA载量与CTL细胞、TLRs表达的关系,分析IM患儿EBV DNA载量、CTL细胞、TLRs表达与临床转归时间的关系。结果 EBV DNA低载量组的CD8+T细胞水平低于高载量组(P<0.05);经抗病毒及对症治疗后,EBV DNA低载量组的临床症状消退时间短于高载量组(P<0.05);Pearson相关性结果显示,IM患儿的CD8+T细胞、TLR7和TLR9 mRNA表达水平与EBV DNA载量均呈正相关(P<0.05);Pearson相关性结果显示,IM患儿的EBV DNA载量、CD8+T细胞、TLR7和TLR9 mRNA表达水平均与临床转归时间呈正相关(P<0.05)。结论 EBV DNA载量、CTL细胞、TLR7和TLR9 mRNA表达水平与IM患儿的临床症状均有一定的相关性,且均可评估病情临床转归情况。

OBJECTIVE To explore the correlation of Epstein-Barr virus(EBV)DNA load and peripheral blood cytotoxic T lymphocytes(CTL),Toll-like receptors(TLRs)and clinical outcomes in children with infectious mononucleosis(IM).METHODS A total of 92 children with IM treated in the First Affiliated Hospitals of Shangqiu Medical College between Jan 2020 and Aug 2021were enrolled as the research subjects.The serum EBV DNA load was detected by reverse transcription polymerase chain reaction(RT-PCR).According to median level of EBV DNA load(3.50 X104 copies/ml),patients were divided into the low-load group(46 cases)and high-load group(46 cases).The expression level of peripheral blood CTL(CD_(8)^(+)T cells)was detected by flow cytometry assay.The mRNA expression levels of TLR7 and TLR9 were detected by RT-PCR.The correlation of EBV DNA load with CTL,TLRs,and their relationship with clinical outcomes were analyzed.RESULTS The level of CD_(8)^(+)T cells in the low-load group was lower than that in the high-load group(P<0.05).After antiviral and symptomatic treatment,disappearance time of clinical symptoms in the low-load group was shorter than that in the high-load group(P<0.05).Pearson correlation analysis showed that expression levels of CD_(8)^(+)T cells,TLR7 and TLR9 mRNA were positively correlated with EBV DNA load(P<0.05);EBV DNA load,expression levels of CD_(8)^(+)T cells,TLR7 and TLR9 mRNA were positively correlated with clinical outcome time(P<0.05).CONCLUSION Certain correlation of EBV DNA load with CTL,TLR7,TLR9 mRNA and clinical symptoms exist in children with IM,which can be used to assess clinical outcomes.